血液疾患患者における血小板輸血単位数と血小板輸血不応との関連：中国におけるコホート研究

Patients with hematologic diseases frequently receive platelet transfusions and exhibit a higher incidence of platelet transfusion refractoriness (PTR). This study assessed whether platelet transfusion units are a risk factor for PTR.

We enrolled 598 patients from the Hematology Department of Chengdu Second People's Hospital (Feb 2020-Feb 2023). Based on CCI values, patients were categorized into PTR (n = 207) and non-PTR (n = 391) groups. The relationship between platelet transfusion units and PTR risk was analyzed using logistic regression, with adjustments for confounders.

The PTR incidence was 34.61 %. Platelet transfusion units were significantly associated with increased PTR risk (OR=1.93, 95 % CI 1.67-2.24, p < 0.001); after adjusting for age, sex, infection, body mass index, disease classification, red blood cell transfusion units, and routine blood test results, this correlation increased higher (OR=2.35, 95 % CI 1.89-2.91, p < 0.001). The fitting curve between the platelet transfusion units and risk of PTR show a positive linear relationship(p = 0.472) Furthermore, when dividing platelet transfusion units into < 3 Units and ≥ 3 Units, patients receiving ≥ 3 Units had a significantly higher risk of PTR (OR=6.17, 95 % CI 4.24-8.97, p < 0.001) compared to those receiving < 3 Units; similarly, after adjusting for covariates, the risk of PTR in patients receiving ≥ 3 Units was still higher (OR=7.38, 95 % CI 4.29-12.69, p < 0.001). After propensity score matching, the risk remained robust (OR=4.59, 95 % CI 2.77-7.61, p < 0.001) across various model corrections.

Platelet transfusion units independently correlate with PTR incidence, suggesting the need for careful assessment and reduction of unnecessary transfusions.